PIETRO v. PRUDENTIAL INSURANCE COMPANY OF AMERICA

The opinion of the court was delivered by: JAMES MORAN, Senior District Judge

MEMORANDUM OPINION AND ORDER

Plaintiff Frank DiPietro brought this ERISA action against defendant
Prudential Insurance Company of America, challenging its denial of
disability benefits under his employee benefits plan. On March 25, 2004,
this court issued a memorandum opinion and order granting plaintiffs
motion for summary judgment and denying defendant's cross-motion for
summary judgment. Defendant now brings a motion for reconsideration
pursuant to Rule 59(e) of the Federal Rules of Civil Procedure. The
motion is denied.

A party can bring a motion for reconsideration to correct errors of law
or fact, or present newly discovered evidence. See Bordelon v. Chicago
School Reform Board of Trustees, 233 F.3d 524, 529 (7th Cir. 2000)(citing
LB Credit Corp. v. Resolution Trust Corp., 49 F.3d 1263 (7th Cir.
1995)). Defendant argues that the court committed two legal errors in
reaching its decision. First, that after finding the plan administrator's
denial of benefits to be "arbitrary and capricious" the court awarded
benefits to plaintiff instead of remanding the claim to the plan
administrator. Second, that the court misapplied the summary judgment
standard in finding for plaintiff. We disagree.

Defendant argues that when reviewing a plan administrator's initial
denial of a claimant's benefits, it is not the district court's place to determine
the claimant's eligibility. It maintains that after finding the plan
administrator's decision to be arbitrary and capricious, the court must
return the plaintiff to the same position he was in before the arbitrary
decision and remand the case to the plan administrator to determine
whether or not the plaintiff is disabled. Indeed, the Seventh Circuit
states in Hackett v. Xerox Corporation Long-Term Disability Income Plan,
315 F.3d 771, 776 (7th Cir. 2003): "In a case where the plan
administrator did not afford adequate procedures in its initial denial of
benefits, the appropriate remedy respecting the status quo and correcting
for the defective procedures is to provide the claimant with the
procedures that she sought in the first place." However, we did not simply
find that the process was inadequate.

In the opinion granting summary judgment for plaintiff, we discussed
the defendant's three proffered reasons for denying plaintiff's claim:
lack of evidence to support his claim;, failure to work to the greatest
extent possible; and failure to follow treatment recommendations. While
discussing defendant's first argument, we highlighted the deficiencies in
its decision  improper assumptions, discrediting of evidence without
justification, and selective review of the evidence. We also recited the
evidence on record that supported plaintiff's claim of disability,
including the medical opinion of Dr. Sliwa, a post-polio specialist; the
recommendations of Maureen Ziegler, an occupational therapist; the report
of Thomas Grzesik, a rehabilitation consultant; the Social Security
Administration's finding of disability; plaintiff's statements; and the
letters of his friends and co-workers. In our opinion we noted the dearth
of evidence to support the determination that plaintiff was not
disabled. Finally, we concluded not just that the plan administrator's
opinion contained procedural deficiencies but that, given this record, it
was unreasonable not to find plaintiff disabled. As we stated, "The
record is clear that plaintiff is entitled to disability benefits," As defendant acknowledges in its own motion, an outright award of
benefits is proper when the decision is "so clear cut that it would be
unreasonable for the plan administrator to deny the application for
benefits on any ground." Gallo v. Amoco. Corp., 102 F.3d 918, 923 (7th
Cir. 1996)(citing Weaver v. Phoenix Home Life Mutual Ins. Co.,
990 F.2d 154, 159 (4th Cir. 1993)). This record provides a clear-cut
case, thus remand is unnecessary. After arbitrarily denying plaintiffs
claim, defendant is not entitled to develop a new record to evaluate
plaintiff's initial eligibility while plaintiff waits without benefits.
Defendant may certainly conduct new tests and exams to determine whether
plaintiff should continue to receive benefits, but the present record
establishes his initial eligibility.

Defendant also argues that the court misapplied the summary judgment
standard by granting plaintiff's motion merely because it found that the
plan administrator's decision was arbitrary and capricious. Defendant
reminds the court that it must consider the merits of each cross-motion
separately. As explained above, we reviewed the evidence that supported
denying defendant's motion and the evidence that supported granting
summary judgment for plaintiff. We did not find for plaintiff merely
because the plan administrator's decision was arbitrary and capricious,
but because the record supports only one reasonable outcome  an
award of disability benefits to plaintiff.

CONCLUSION

For the foregoing reasons, defendant's motion to reconsider is denied.

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